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1265436240

NPI Code Detail

MEDICARE: DR. WILLIAM J. BANKS MD

MEDICARE: DR. WILLIAM J. BANKS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085P0229X	Pediatric Radiology Physician	J6072	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	143159503	OTHER	TX	CSHCN2
4	300121249	OTHER		RRMCARE1
5	143159502	OTHER	TX	CSHCN1
6	300127468	OTHER		RRMCARE2

General Provider Information

NPI Number	:	1265436240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM J. BANKS MD

Provider Business Mailing Address
First Line	:	12554 RIATA VISTA CIR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-6431
Country	:	US
Telephone Number	:	512-795-5100
Fax Number	:	512-795-5122

Provider Business Practice Location Address
First Line	:	12554 RIATA VISTA CIR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-6431
Country	:	US
Telephone Number	:	512-795-5100
Fax Number	:	512-795-5122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	01/12/2015

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Directions to “ DR. WILLIAM J. BANKS MD” Practice Location

Language	Start Address	Practice Location

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